Journal of Urgent Care Medicine

A 52-Year-Old Male with Shortness of Breath and a History of Multiple Cardiologic Issues

A 52-year-old male with a history of hypertension, hyperlipidemia, and recent myocardial infarction (1 month ago) presents to urgent care with shortness of breath for the past week. He denies fever, chest pain, or cough. On examination, the patient is breathing comfortably and saturating well on ambient air. Review the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

COVID-19 Has Had a Strong Impact on Pediatric Presentations—Well Beyond the Virus Itself

The effects of SARS-CoV-2 itself on various populations in the United States and internationally have been well-documented. Likewise, an ever-growing number of studies have measured the effects of the pandemic on healthcare, the workforce, children’s education…and on and on. One fact that has been largely overlooked: While social distancing and mask mandates helped reduce spread of COVID-19, with the unintended benefit of reducing the number of cases of other infectious diseases, they did nothing …

A 7-Year-Old Boy with New Facial Rash

A woman brings her 7-year-old son to the urgent care center with a rash that had developed “over the past few weeks.” On examination, there are smooth, pink papules around the mouth. The mother reports that the patient has a history of asthma, for which he uses inhalation budesonide daily as maintenance therapy. Otherwise he is healthy, has no systemic symptoms, and is well-appearing. View the photo taken and consider what your diagnosis and next …

Atypical Chest Pain Reveals Rare T-Cell Lymphoblastic Lymphoma: A Case Report

Urgent message: Not all patients presenting to urgent care with chest pain require immediate transfer to a higher-acuity setting. Rather, immediate evaluation in the urgent care center can inform next steps for management on site or, in the event of truly emergent symptoms, transfer. Tushar Menon, MD; Sahil Kapur, DO; Ameera C. Mistry, MD; and David M. Boyd, MD Key words: T-call lymphoblastic lymphoma, non-Hodgkin’s lymphoma, anterior mediastinal mass, chest pain ABSTRACT Chest pain patients …

Abstracts in Urgent Care – February 2023

Ivan Koay MBChB, MRCS, FRNZCUC, MD Quinolone Eardrops and Achilles Tendon-Related Outcomes Take-home point: Quinolone eardrops were associated with an increased risk of all-type tendon rupture, including Achilles tendon (AT), but not AT tendinitis. Citation: Tran P, Antonelli P and Winterstein A. Quinolone ear drops and Achilles tendon rupture. Clin Infect Dis. 2022; ciac709. Epub ahead of print September 6, 2022. Relevance: Systemic quinolones have been known to increase the risk of tendon rupture. Prior …

A New 4-Year-Old Patient with Fever and Sore Throat After a COVID Exposure

Bradley L. Laymon, PA-C, CPC, CEMC PRESENTATION A mother brings in her 4-year-old, who has never visited your urgent care center before, with complaints of fever and sore throat. The mother provides the HPI. She explains that the child’s symptoms have been present for 2 days. During that time, the patient’s temperature rose to a high of 101.5°F (38.6°C). Ibuprofen has been effective in reducing the fever. The girl was exposed to COVID-19 at daycare …

2023 Trends for Urgent Care

Urgent Message: Five trends will drive urgent care strategy in 2023, including its continued response to COVID-19, building bridges with the pediatric community, integration of urgent and primary care, integration of specialist services, and increased operational efficiency in response to staffing challenges. Alan A. Ayers, MBA, MAcc is President of Experity Consulting and is Practice Management Editor of The Journal of Urgent Care Medicine. As we embark upon 2023, year of the “rabbit” in the …

Yes, You Can Remove Corneal Foreign Bodies and Rust Rings in Urgent Care

John J. Koehler MD, ABPM(OM) I trained in Emergency Medicine in the 1980s and learned to use a slit lamp as an intern; it’s a skill that continues to serve me to this day. We had “opti-spuds” to remove foreign bodies and “opti-burrs” to debride rust rings. This was considered a core skill in my training. This is why, when I started Physicians Immediate Care in 1987, I bought a slit lamp as well as …

A 70-Year-Old Male Who Presents in a Confused State

A 70-year-old male presents to urgent care with confusion. On exam, the patient is tachypneic and is, indeed, confused but is able to follow commands. View the initial ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

A 41-Year-Old Woman with a History of SLE and Sudden-Onset Sores on Her Limbs

A 41-year-old woman with a history of systemic lupus erythematosus presents for evaluation of painful areas that had developed on her upper, outer arms and lateral thighs over the past month. She reports that while the affected areas were initially smooth, some had begun to ulcerate. View the photo taken and consider what your diagnosis and next steps would be.